Statutory Appointment - Daily Report

• Site conducted

  Select

• Conducted on

  Date

• Prepared by

  Select Craig Ormsby Ryan Bazzica Bek Dye Riki Tamati Nelson Jones George Kokkoris Bryce Harnett Other

  • Craig Ormsby
  • Ryan Bazzica
  • Bek Dye
  • Riki Tamati
  • Nelson Jones
  • George Kokkoris
  • Bryce Harnett
  • Other
• Location
  Address

• Statutory Appointment

  Select Craig Ormsby Ryan Bazzica Bek Dye Riki Tamati Nelson Jones George Kokkoris Bryce Harnett Other

  • Craig Ormsby
  • Ryan Bazzica
  • Bek Dye
  • Riki Tamati
  • Nelson Jones
  • George Kokkoris
  • Bryce Harnett
  • Other

• Date

  Date

Shift

• Crew

  A Crew

  B Crew

  C Crew

  D Crew

• SEM Capability https://forms.office.com/r/Geit0hfyNL

Daily Tasks

• Vehicle Pre-starts completed

  Completed - All Operational

  Completed - Non Operational

• Daily Workplace Inspections

  Select Not Required Today Completed - Nil Issues Completed - Minor Issues - Rectified Completed - Major Issue(s) - Notification Raised

  • Not Required Today
  • Completed - Nil Issues
  • Completed - Minor Issues - Rectified
  • Completed - Major Issue(s) - Notification Raised

• Equipment Inspected

  Select Equipment Inspected - All Operational Equipment Inspected - Minor Issues - Rectified Equipment Inspected - Major Issues - Tagged Out of Service

  • Equipment Inspected - All Operational
  • Equipment Inspected - Minor Issues - Rectified
  • Equipment Inspected - Major Issues - Tagged Out of Service

Incident Callouts

• Fire Alarms

  Nil

  Active Fire Alarm Response

• Medical Events

  Select Nil Medical Event - General Medical Event - Priority 1 Medical Event - Priority 2 Medical Event - Priority 3 Medical Event - Road Transfer Medical Event - HEMS Transfer Medical Event - RFDS Transfer

  • Nil
  • Medical Event - General
  • Medical Event - Priority 1
  • Medical Event - Priority 2
  • Medical Event - Priority 3
  • Medical Event - Road Transfer
  • Medical Event - HEMS Transfer
  • Medical Event - RFDS Transfer

• Fire and/or Rescue

  Select Nil Facility and/or Infrastructure Fire Engulfed by product Confined Space Incident Extreme Weather Incident - Bush Fire Extreme Weather Incident - Cyclone Processing Plant Fire Aviation Accident Uncontrolled Dropped or falling objects Working at Height Incident Lifting and Cranage Incident Vehicle Interaction Incident Electrocution Uncontrolled release of diesel Uncontrolled including Rollaway Rolling Stock Maintenance Uncontrolled release of stored energy Fire and / or Explosion Incident Bus Incident Haz Mat Response Search & Rescue Security Event

  • Nil
  • Facility and/or Infrastructure Fire
  • Engulfed by product
  • Confined Space Incident
  • Extreme Weather Incident - Bush Fire
  • Extreme Weather Incident - Cyclone
  • Processing Plant Fire
  • Aviation Accident
  • Uncontrolled Dropped or falling objects
  • Working at Height Incident
  • Lifting and Cranage Incident
  • Vehicle Interaction Incident
  • Electrocution
  • Uncontrolled release of diesel
  • Uncontrolled including Rollaway Rolling Stock Maintenance
  • Uncontrolled release of stored energy
  • Fire and / or Explosion Incident
  • Bus Incident
  • Haz Mat Response
  • Search & Rescue
  • Security Event

Ongoing Tasks

• High Risk Works

Other Information

• Additional Information

Confirmation of Handover

• Outgoing S26 Signature

  Sign